Neighborhood problems and nocturnal blood pressure dipping.

Abstract

Objective Living in adverse neighborhood conditions has been linked with greater prevalence of cardiovascular disease (CVD). We aimed to learn whether perceived neighborhood problems are related to attenuated nocturnal blood pressure (BP) dipping, a risk factor for CVD morbidity. Method A sample of 133 adults (71 male, 62 female; 80 White, 53 Black) underwent 24-hr ambulatory blood pressure monitoring. The neighborhood problem scale (NPS) was used to assess neighborhood environmental stressors. Results Nocturnal dipping in systolic (SBP), diastolic (DBP) and mean arterial (MAP) blood pressure was reduced in individuals with higher NPS scores (p < .05). Hierarchical regression analyses revealed that neighborhood problems explained 4%–6% of the variance in SBP, DBP, and MAP dipping (p < .05) even after adjusting for several theoretical confounders such as social status, age, gender, race, body mass index (BMI), smoking, exercise, depression and discrimination. Conclusion Neighborhood problems may contribute to attenuated BP dipping beyond the effect of known risk factors.

Blood Pressure Dipping and Urban Stressors in Young Adult African Americans

“…BP dipping was specifically related to the neighborhood disorder subscale which queries exposure to crimes, police activity, drug-related, and other threatening neighborhood activity (16). These items overlap the scale utilized by Euteneuer et al (7) that has items referencing crime, vandalism, litter and noise. Our study provides validation of these relationships in demonstrating a similar strength relationship of BP dipping with poverty rates.…”

“…This effect has been hypothesized to be a consequence of the stress of ongoing threat engendered by high unemployment rates, crime, and physical decay, as well as limited opportunities for physical activity and purchasing healthy food (6). In a recent study of 133 adults of whom 53 were Black, a measure of neighborhood problems accounted for 6% of the variance in nocturnal dipping of mean arterial blood pressure (MAP) independent of social status, age, gender, race, body mass index (BMI), smoking, exercise, depression and discrimination (7). Violence exposure has been linked to BP non-dipping in adolescents (5) and to posttraumatic stress disorder (PTSD) (8) and PTSD has been prospectively linked to cardiovascular disease (9).…”

Neuro-Bio-Behavioral Mechanisms of Placebo and Nocebo Responses: Implications for Clinical Trials and Clinical Practice

“…We need to discover which biologic system and physiologic processes in sleep regulation are vulnerable to expectation and conditioning influences (e.g., the ascending neuronal system including the reticular formation, thalamus, and forebrain neurons; the descending neuronal pathways encompassing neuronal activities in the hypothalamus, brain stem, and spinal cord; neurotransmitter systems such as the glutamatergic system, GABA, noradrenaline, dopamine, and serotonin sensitive receptors; behavioral arousal and muscle tone (Jones, 2011). Sleep is closely associated with the restoration of physiologic systems, such as nocturnal blood pressure dipping and changes in immune functions (Rief et al, 2010;Euteneuer et al, 2014), but it is also relevant for processes such as recreation and memory consolidation (Weber et al, 2014), and placebo responses in these sleep-associated factors also need to be addressed.…”

Neighbourhood socioeconomic characteristics and blood pressure among Jamaican youth: a pooled analysis of data from observational studies

“…With regards to blood pressure, associations have been reported for systolic blood pressure, diastolic blood pressure and hypertension (Coulon et al, 2016;Fan et al, 2015;Liu et al, 2013), using indicators such as community level income, poverty, social and environmental characteristics and 'perceived neighbourhood crime and satisfaction'. Additionally, associations have been reported between attenuation of the normal nocturnal decrease in blood pressure (dipping) and higher levels of perceived neighbourhood problems (Euteneuer et al, 2014). Studies have also shown associations between neighbourhood characteristic and blood pressure in youth (McGrath, Matthews & Brady, 2006).…”